Abstract 15196: Statin Use and Titration Patterns in the First Year Following a Cardiovascular Event in Commercially-Insured Populations

• Published in: Circulation (New York, N.Y.) Vol. 134; no. Suppl_1 Suppl 1; p. A15196
• Main Authors: Beaubrun, Anne C, Monda, Keri L, Kim, Deborah, Mues, Katherine, Bradbury, Brian D, Rosenson, Robert S, Muntner, Paul, Herzog, Charles A
• Format: Journal Article
• Language: English
• Published: by the American College of Cardiology Foundation and the American Heart Association, Inc 11.11.2016
• ISSN: 0009-7322; 1524-4539

IntroductionGuidelines recommend statin treatment for patients with established cardiovascular disease (CVD). We determined the real-word use and titration of statins after an atherosclerotic CVD event from two commercial claims databases.MethodsThe first occurrence of MI, unstable angina, ischemic stroke, or TIA in 2012 was identified for each patient using ICD-9 CM diagnosis codes from the MarketScan and Optum databases. During the ensuing 1 year, we evaluated statin use and titration in the first and second 6-month follow-up periods. Prevalent statin users were defined as those on a statin at the time of the CVD event.ResultsThe 183,752 MarketScan patients were slightly younger (mean age 67.3 years) and 54.6% were male vs. the 63,199 Optum patients (mean age 72.4 years) where 51.4% were male. Among the MarketScan patients, 36.4% used a statin in both the first and second 6-month periods following hospital discharge, 13.2% used a statin only in the first period, 1.6% used a statin only in the second period, and 48.8% did not use a statin in either period. Among the Optum patients, 46.2% used a statin in both the first and second 6-month periods following hospital discharge, 15.8% used a statin only in the first period, 1.8% used a statin only in the second period, and 36.2% did not use a statin in either period. When restricted to prevalent statin users in MarketScan (N=65,406), 71.7% used a statin in both the first and second 6-month periods, 25.3% used a statin only in the first period, 0.2% used a statin only in the second period, and 2.8% did not use a statin in either period. Similar results were observed in the 27,462 prevalent statin users in Optum. Among the 66,849 MarketScan patients who used a statin in both periods, 92.8% maintained a consistent dose, 4.3% up-titrated and 3.0% down-titrated. Titration results were similar in Optum and when restricted to prevalent statin users.ConclusionsBetween a third and half of patients experiencing a major CVD event did not receive recommended therapy highlighting an existing treatment gap.